| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,382 |
3,104 |
$233K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,200 |
1,647 |
$76K |
| A4554 |
Disposable underpads, all sizes |
1,389 |
1,010 |
$64K |
| A7030 |
Full face mask used with positive airway pressure device, each |
966 |
738 |
$51K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,174 |
1,495 |
$48K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,651 |
1,884 |
$24K |
| A7031 |
Face mask interface, replacement for full face mask, each |
905 |
603 |
$21K |
| K0001 |
Standard wheelchair |
2,432 |
1,778 |
$19K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
152 |
112 |
$16K |
| E0570 |
Nebulizer, with compressor |
1,231 |
845 |
$11K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
63 |
52 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
665 |
477 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
592 |
452 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,782 |
1,289 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
393 |
311 |
$6K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
101 |
87 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
233 |
189 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
93 |
75 |
$192.40 |